{include file="header.tpl.php"}



<div class="titleFull">

	<div class="wrapper">

		<h1 style="line-height: 100px; margin: 0px;">Registration</h1>

	</div>

</div>


<div class="titleBlueBar"></div>




<div class="content">

	<div class="wrapper">


		<div class="h40"></div>

		<div class="boxLeft">

		<form action="register.php" method="post">
		<input type="hidden" name="register" value="register" />



			<div class="h10"></div>

			{if $error_msg ne ""}<div class="red">{$error_msg}</div><br>
			<div class="dottedline"></div><br>
			{/if}

			<div class="boxLeftLeft">
			First Name<br>
			Last Name<br>
			Home Address<br>
			City/Town<br>
			State/Province<br>
			Zip/Postal Code<br>
			Country<br>
			Email Address<br>
			Confirm Email<br>
			Username<br>
			&nbsp;<br>
			Password<br>
			Confirm Password<br>
			Promotional Methods<br><br><br><br>
			&nbsp;<br><br>
			Security Code<br>
			&nbsp;<br>
			</div>

			<div class="boxLeftRight">
			<input type="text" name="first_name" value="{$first_name}" /><br>
			<input type="text" name="last_name" value="{$last_name}" /><br>
			<input type="text" name="address" value="{$address}" /><br>
			<input type="text" name="city" value="{$city}" /><br>
			<input type="text" name="state" value="{$state}" /><br>
			<input type="text" name="zip" value="{$zip}" /><br>
			<input type="text" name="country" value="{$country}" /><br>
			<input type="text" name="email_address" value="{$email_address}" /><br>
			<input type="text" name="email_confirm" autocomplete="off" /><br>
			<input type="text" name="username" value="{$username}" onblur="checkUsernameAvailablity(this.value)" onkeydown="clearStMsg()"  /><br>
			<div style="height: 45px; width: 370px;" id="username_status"></div>
			<input type="password" name="password" autocomplete="off" /><br>
			<input type="password" name="password_confirm" autocomplete="off" /><br>
			<textarea style="height: 200px; width: 330px;" name="promotional_methods">{$promotional_methods}</textarea><br>
			<img src="captcha.php" alt="" /><br>
			<input type="text" name="code" autocomplete="off" /><br>
			<input type="checkbox" name="agreed" value="1" /> I agree to <a href="{$SITE_URL}terms.php" class="agree" target="_blank">terms of service</a><br>
			</div>

			<div class="h20"></div>

			<center><input type="submit" class="button" value="Register Now" title="Register Now"></input></center>

			<div class="h20"></div>

			<div class="dottedline"></div>

			<br>
			<center><a href="login.php">Already have an account? Login now!</a> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <a href="forgot.php">Forgot your password?</a></center>



		</form>

		</div>

		<div class="boxBetween"></div>

		<div class="boxRight">
		
			<div class="howStep" style="margin-top: 20px;">
			<div class="number" style="width: 48px;">1</div>
			<div class="text" style="width: 239px;">Upload your files and promote them on the internet.</div>
			</div>

			<div class="howStep" style="margin-top: 20px;">
			<div class="number">2</div>
			<div class="text">Visitors complete a quick survey to download your files.</div>
			</div>

			<div class="howStep" style="margin-top: 20px;">
			<div class="number">3</div>
			<div class="text">You earn an average of $1 for every completed survey.</div>
			</div>
		
		</div>

		<div class="h40"></div>

	</div>

</div>




{include file="footer.tpl.php"}